JWAN SHARIFZADEH

Bukan_Dental problems in Iran are no longer just about health; rising treatment costs have made access to a dentist a challenge for many people.With expensive medications and treatments and the lack of adequate insurance coverage,dental pain for some patients turns into a financial burden that forces them to delay treatment or even extract teeth that could have been saved.

"Last year, I applied for a loan of 100 million tomans to fix my teeth. by the time i received the loan, prices had increased several times over. Now, 100 million tomans barely covers the coat of two dental implants."  This is what Zeinab M., a 50-year-old woman from Bukan, said. She had to extract all her upper jaw teeth due to illness, but rising prices_driven by the dollar's value and inflation_have made even smilling a source of embarrassment for her.

Dental services in clinics are not covered by insurance,and only a limited number of insurance companies cover these services, and only pertially. In general, no comprehensive plan or public budget has been allocated for this sectr to date.

Estimates indicate that more than 55% of Iranians over the age of 65 have no natural teeth, while people between the ages of 30 and 40 have lost at least 12 teeth.

Painkillers as a Substitute for Treatment

Dental service prices have risen to the point that they are beyond the reach of the middle and low-income classes. A simple dental examination fee, which even a year or two ago was completely free, now ranges between 300,000 and 600.000 tomans in clinics.

Perviously, the phrase "dental treatment in installments" could be seen on the windows of many clinics, but many dentists are no longer able to offer installment plans.

People prefer to endure the pain rather than bear these exorbitant costs. Ronak . Kh., a 35-year-old woman, like many others, soothes her pain with anesthetic drops. She says: "The dentist said my tooth needs a root canal. The cost of root canal treatment a few months ago in the simplest dental clinic was about 8 million tomans, but I said, let it be. It's better to endure the pain and not eat on that side of my mouth."

Currently, the cost of simplest dental procedures_such as fillings, root canals, wisdom tooth surgery,and extractions_is approximately 4 million, 12 million, 12 million, 8 million,and 2 million tomans, respectively.

As for dental implants, which years ago could be performed at an affordable cost, they now start from 20 million tomans and above, depending on the brand and country of manufacture. Added to this are bone grafting and accompanying surgical costs, which can exceed 15 million tomans extra. Dental crowns range between 5 and 15 million tomans per patient.

From Forced Extraction to Declining Treatment Quality

A dentist (S.A.) In Bukan confirmed that people are shying away from specialized dental services,describing the situation as a crisis threatening future health. "People postpone dental treatment and only visit a dentist when it becomes chronic. High costs often lead patients to choose the cheapest option—tooth extraction rather than treatment—even in cases where the tooth could be saved. Sometimes the patient has delayed so long that there is no longer any possibility of saving the tooth. Even during examinations, due to the economic situation, we often suggest treating teeth that may become emergencies."

The huge price increases in this sector have not only limited people's access to treatment but have also affected service quality. Many clinics, due to rising material and equipment costs, have been forced to use cheaper but lower-quality alternatives.

If the materials are counterfeit, they may easily fall out, forcing the patient to pay additional costs for reattachment. The use of counterfeit materials in dental restorations can also lead to nerve death after about a month, again forcing the patient to undergo root canal treatment and restoration.

Economic Pain

Class and gender gaps persist in oral and dental health, but the current economic crisis has become a comprehensive crisis affecting different groups. If the current trend continues, the prices of dental services are expected to keep rising in the coming years. In this case, dental pain will no longer be just physical pain; it may exceed being an economic problem to become a health and social crisis.

Without reforming economic and supportive structures, equitable access to dental services will remain a serious challenge for broad segments of society, particularly women.